Brief observation
Influence of the menstrual cycle on the timing of acute coronary events in premenopausal women

https://doi.org/10.1016/S0002-9343(03)00051-2Get rights and content

Section snippets

Study sample

We studied 27 consecutive premenopausal women hospitalized between 1996 and 2000 for the treatment of an acute coronary syndrome (acute myocardial infarction or unstable angina). We excluded women with irregular menstrual cycles or previous hysterectomy, or who used oral contraceptives. The study was approved by the ethics committees of the two participating hospitals (Laval Hospital and Hôtel-Dieu de Lévis Hospital). All study participants provided written informed consent.

Definition of acute coronary events

The diagnosis of

Results

All women had at least one known risk factor for coronary artery disease; the most common was a family history of cardiovascular disease (Table). The mean (± SD) age of the 27 women was 43 ± 4 years (range, 33 to 51 years). Their mean menstrual cycle length was 26 ± 3 days. All of the acute coronary events (n = 27) occurred within the first half of the menstrual cycle (P <0.00001 compared with no events during the second half of the menstrual cycle). Significantly more women (19 vs. 8 women)

Discussion

Because coronary artery disease is infrequent in premenopausal women, the effect of acute hormonal fluctuations on the timing of cardiovascular disease events is not well defined. Our study shows that most premenopausal women who have an acute coronary event do so during menses, raising the possibility that low 17β-estradiol levels during menses are associated with, or perhaps contribute to, the increased risk of an acute coronary event. However, none of the coronary events occurred during the

Acknowledgements

We would like to thank Jacynthe Harnois, RN, from Laval Hospital, for her assistance. We would also like to acknowledge the recruitment contributions of Dr. Réjean Loisel, as well as Francine Dumont, RN, and Noëlla Bilodeau, RN, from the Hôtel-Dieu de Lévis Hospital.

First page preview

First page preview
Click to open first page preview

References (27)

  • T.L. Bush

    Estrogen replacement and coronary artery disease: the evidence for primary and secondary prevention

    J Clin Endocrinol Metab

    (1996)
  • F. Grodstein et al.

    Postmenopausal hormone therapy and mortality

    N Engl J Med

    (1997)
  • D.M. Herrington et al.

    Effects of estrogen replacement on the progression of coronary-artery atherosclerosis

    N Engl J Med

    (2000)
  • Cited by (0)

    This study was funded by the Fonds de la Recherche en Santé du Québec, Montreal, Quebec, Canada, and the Canadian Institutes of Health Research, Ottawa, Canada. Julie Méthot is a Research Scholar from the Canadian Institutes of Health Research.

    View full text